Individual
MARK TOMERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7579 LAKE ST, RIVER FOREST, IL 60305-1846
(708) 366-7177
(708) 366-3301
Mailing address
PO BOX 616, FOREST PARK, IL 60130-0616
(708) 366-7177
(708) 366-3301
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036065652
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036065652
—
IL
01
—
31603127
BCBS
IL
Enumeration date
09/26/2006
Last updated
07/01/2008
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